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Rethinking heart health, one question at a time.
I’m Dr. Sanjay Bhojraj—interventional cardiologist, functional medicine expert, and lifelong student of what really keeps us well. In this podcast, we go beyond prescriptions and procedures to explore the deeper drivers of health, disease, and healing.
From inflammation to intuition, cholesterol to consciousness, I sit down with doctors, researchers, and changemakers who are reshaping how we think about the heart—and the whole human behind it.
Whether you're a fellow clinician, a health seeker, or someone navigating your own transformation, this show will challenge what you thought you knew—and invite you to stay curious.
Sanjay Bhojraj MD (00:01.176)
Hey everybody and welcome to this episode of the Curious Cardiologist podcast. Super excited today because today, April 1st, 2026 is the start of season two of this podcast. Never did I think that we would make it to a season two or probably a season one for that matter, but the response has been so great and I am excited to continue along this journey with you audio, visual, wherever you're watching or listening on the podcast.
Today we're gonna do a little bit something different. In season two, we have a lot of things to debut, but I'm gonna start solo episodes where I let you in to my brain. It's a great place to be if you're me, but I just wanted you guys to get a sense of me and how it is that I approach things, and we can talk about any topic that you want. I've had a lot of requests on social media to cover certain things and do a deep dive, which we'll totally do. But today I wanted to start
with something that is very near and dear to my heart as I have now restarted clinical medicine, which we'll talk about here in a moment, but have become more of a consumer of healthcare than a provider. I've been taking family members to the doctor now in terms of my in-laws and wife and kids. And I've just had one question after this experience of being on the other side of the stethoscope is when did doctors stop
being doctors. I don't sound strange, but it is so frustrating for me to see what's become of my profession, to go to these doctor visits and have someone who is supposed to be in a very sacred relationship with you, a very trusting relationship where you're feeling most vulnerable, where people's eyes aren't even looking at you, right? They're just typing on a screen, typing away. We have more tech, more meds,
And fortunately or unfortunately more data than ever. And I think it's just leading to a lot of confusion. And so I think back to my med school days when we, I mean, we still had technology. The world wasn't in black and white like my daughters think it was back in the 1900s, right? But, but we were focused on physical examination skills and talking to people and connecting. And I feel that in this day and age,
Sanjay Bhojraj MD (02:25.474)
that connection is more important than ever. We need our doctors to connect. And I just don't feel that it's happening. And honestly, something feels broken. And where did this come from? Well, let me share a story that I had with a recent family member visit for chronic conditions. So one of my family members is having severe dizziness, like can't function dizziness. And as I see it in my world, there's not just, when I learn and ask questions,
There wasn't just one type of dizziness. There's actually three types. There was a positional, there was a stress related, and an inner ear type issue. And the doctor in our local area who sees this had month long waiting lists. So a family member put in for an appointment, I think it was like in like September or October, for a visit in February or March. I we're talking about months away. And the reason this came to pass was that
in speaking with other members of the community, it was thought that this doctor was a specialist in dizziness. And for months, there's a lot of anticipation. my gosh, I'm going to feel so much better after we get into this doctor's office. And so as I am, you know, wanted to do, said, you know what, let me just come with you. I can help frame the questions and help that communication happen a little bit more directly. And so I was really a fly on the wall. And this
Physician was not somebody that I know outside of my medical group. So they didn't know that I was a doctor, although it came up in conversation later. But I just kind of sat in as a fly on the wall initially. And this was the experience. Now remember, this is someone who came very highly recommended, both through Facebook community groups, and so online forums, as well as a personal referral through somebody at our temple. And so I was like, wow, this is gonna be great. Neurology is not.
my area of expertise, although I studied it in med school and all these things, let me go. And I would really love to see how this person who's an expert teases this apart because I think it's a very complex problem. And honestly, the appointment experience was dissatisfying. Maybe it wouldn't even be the right term. think disappointing is probably the best I can come up with, It says, as parent, you're so mad you're disappointed. Well, I felt so cheated and so just disappointed in the entire experience.
Sanjay Bhojraj MD (04:49.88)
for reasons that we'll get into. But when the prior came in, came in with a medical student who I love, I love when there's a student there. Again, to me, when there's a student, that means that perhaps this person is worth learning from, right? So it even further underlines their expertise. But as the clinical encounter unfolded, it was just a bunch of quick questions. You're dizzy, yes, when does it happen? Here, does it happen with this? Yes, have you tried this? No. And probably for the entire
I mean, it was a pretty long encounter. fell, I kind of forced it into a longer encounter than I'm sure the practitioner was, was happy with. But for, let's say the 30 minutes of the encounter, 45 minutes of the counter, I almost feel like maybe 5 % of the time, the doc was actually looking at my family member. They were just looking at the computer the entire time. How frustrating is it to with a doc? How do you tell a story if somebody's looking at you? Right? When your kids are
you know, sitting there, you know, my teenagers are kind of buried, head buried in their phone. What's the first thing you say? Hey, look at me, right? It seems like a very simple doctor thing to do, but head was buried in and really just focused on the chart, not on the story. And I could almost see the wheels turning and said, okay, dizziness equals this medication. Really barely explored the symptoms and said, hey, you know what? We're gonna put you on a tricyclic antidepressant. So for those of you who don't know it,
but tricyclic antidepressant. These were like back in the 80s and 90s. These are old drugs with a lot of drug-drug interactions and they are just messy, right? And you have been listening to the podcast for a while. You know, I'm all about non-medical things, right? As much as we can, push diet, push lifestyle, look for stress, look for these other triggers of symptoms. And what I realized is that the doc...
barely even explored what I thought were the three layers of dizziness, which again is a complex symptom. And I said, hey, you know what? think that jumping to medicines is a little bit quick. And as I see it, there's three layers to this. Again, there's the simple old fashioned positional stuff where when you turn your head and move getting out of bed, that becomes an issue. But there are two other flavors in here, right? There's the stress, so when there's emotional stress happening,
Sanjay Bhojraj MD (07:07.586)
That sets off this cascade of dizziness. And there's also the inner ear type. And I was expecting this great physical examination in the way that I had to learn in medical school. I I remember training so long ago. Of course, we had MRIs, but they weren't readily available, even in the 1900s. But we had to localize strokes, complex strokes, on physical examination. And looking back, what an elegant thing to be able to do. I'm not nearly as good at that as I am.
now, but at least I know that there are maneuvers and things and techniques to be able to differentiate where in the brain something is going wrong. And at this point, it almost felt like the physical exam was an afterthought. OK, well, you know, if you want a physical exam, sure, I can put you through one. I'm not sure what it's going to show. Or I mean, even more scary to me was the possibility that the doc didn't know how to do all those physical examinations. And again, this is a brain specialist. So again, I had to step in.
clarify multiple symptom patterns. And on the back end of it, ultimately what the doc ordered was another brain scan, which we've had those before, and ordered this medication. And I said, let's just have the prescription available just as an in case. it didn't feel the way I think medicine is supposed to feel. There's no emotional connection with the doc.
And I think that aura that you create that I know it sounds kind of woo woo in California, but that's why I guess I'm here in California. But there's a certain energy transfer that happens in these clinical encounters. And when I was seeing patients in clinic and now I'm doing a telemedicine stint, it takes a lot of emotion and a lot of energy. And I think even more so over an online platform to be able to sense what's happening and to get a bigger understanding of
you know, who is this person as a whole? And what am I really trying to fix here for them, right? Like maybe they're having symptoms, but there's a root cause difference here. And it just left me with such a weird taste in my mouth. And that was one doc. Then I took my father-in-law to another doctor, of all things, for a cardiac appointment. And kind of a similar thing. mean, the vibe, it didn't feel like there was connection, right? And what, you know,
Sanjay Bhojraj MD (09:34.156)
Doctors, I think, are trying to do the best they can. I will never speak ill of docs in the sense that I don't think anybody's doing this on purpose. And honestly, I think the systems are not set up for the kind of healing that needs to happen in a physician encounter. Because it's really just, let's put you in a bucket, let's give you a diagnosis, and let's get you to a medication or do a scan and kind of kick the can down. You know, I'll follow up with you in three months and let's see what happens. How many of you guys have heard that line which
you know, drives me crazy. Well, this lab kind of looks weird or there's something funny on your scan. Let's just maybe, you know, re-scan or check another lab in six months and see where this trends, right? Man, like imagine if that were a cancer or imagine if that was the difference between, you know, having a stroke and not having a stroke or having a heart attack or not having a heart attack. mean, we need to get in our preventative mode so much more aggressively. And again, when we look at symptoms,
It's very difficult because things like migraine, vertigo, anxiety, even dropping your blood pressure are important signs, but they can be multiple things. So for instance, when I was talking with it, I'm like, could this be what's called a vestibular migraine, which is a type of migraine where you don't have headache pain, but you get off kilter, you get that dizziness. Could it be multifactorial? What's going on? And for this family member who is relatively young,
You know, why is this happening? And there is no real explanation as to the why. was just a bunch of, mean, I feel like most doctors become like nested if then statements, right? If this number is high, then give this medication to bring this number down. If this number is low, then give this medication to bring this number up. There's, you know, I almost feel like sometimes artificial intelligence would be an upgrade for the medical care that most people are getting because at least with artificial intelligence, there's a lot more.
assimilation of context and a lot more assimilation of the entire body of medical information, not just, well, if you have this symptom, then take this drug. There seems to be something worried. just something feels off. And again, doctors, I think, are doing the best they can. But I think this is a system problem. When you think about how this works, our encounter went probably 15 minutes over the allotted time of a 30-minute new
Sanjay Bhojraj MD (12:01.486)
consult. used to see patients in 30, 30 minute and 15 minute encounters as well. So I get it. I was there right now. I spent an hour on an initial consult with a patient, but you know, it's just that system pressure, right? When you have 30 minutes and you're assimilating all this information and you're dealing with, you know, documentation and, and, know, and you're probably already late from the other patient visits that you had, right? Like the first flight of the day is the only one that ever leaves on time. And then everything else, these micro delays add up.
So the current system of medical care like really rewards speed in terms of decision-making not exploration and curiosity right not trying to get to the why this is happening, but just how quickly can it happen and then again You know the system is set up where you have one Organ one doctor right you see a cardiologist for heart issues. You see a neurologist for brain issues. You see an endocrinologist
for hormone issues. And that does a great disservice to the human body because as they often say, there is no one way arrow in all of biology. Everything points both ways. So you've got the heart speaking to the brain, the brain speaking to the gut, the gut speaking to the heart, the liver speaking to the kidneys, the kidneys speaking to the heart. Like everything is interconnected. And when we take this taxonomy approach of one doctor for one organ, it really just robs patients.
of the true care that they need, right? We're fragmenting and no one is putting it all together. And the reason this is important is here's something most people don't realize, is that chronic symptoms rarely have one cause. So for instance, I, functional medicine, integrative medicine trained, as I look at this complaint of dizziness, for instance, there's a couple of things that can be off. First, the autonomic nervous system, that fight or flight.
and cool and repair and relax and digest mode, that balance is probably off. And there's really no assessment of the autonomic nervous system. One of the first questions I asked of my family member is, hey, what is your heart rate variability? Are you stressed out when this is happening? Potentially that can cause vasoconstriction or something. So there's that autonomic nervous system. Then there's blood pressure regulation. When is this happening? Is it happening in the day?
Sanjay Bhojraj MD (14:28.002)
like during the daytime when you've been sitting in a chair and up and awake for a while? Or is it kind of first thing in the morning when you're laying down and you go to stand up, right? Or sit up out of bed. Maybe there's some problem with the way that our brain is connected to our nervous system. you know, there's some more exercise needed. Is there inflammation happening? Of course, you guys know if you listen to the podcast, inflammation is the key to everything. Information gone awry leads to inflammation aging. As we talk about longevity medicine and getting older.
So much awesome research that inflammation drives mitochondrial dysfunction, diabetes, cancer risk, brain fog, all of these things, but where are we with our inflammatory status? Sleep, such a central thing. And I think one of the most under-recognized risk factors for pretty much anything in life. It's a risk factor for cardiovascular issues, of course, for hypertension, for heart attack. It's a risk factor for cancers, for metabolic syndrome, hormonal dysfunction. If you're not sleeping,
You're not healthy, but there's not a single question asked about sleep and stress physiology. How do you stress? Are you someone that carries that stress to your gut? I remember when I was in high school, I'll share with you now before AP exams, we're reaching AP exam season here in the United States if you've got high schoolers. I remember I would have to drop a deuce before my AP exam. I had just a super nervous stomach. Luckily, I got over it, but I carried a lot of that in my gut. Again.
brain-gut axis, right, and how hormones respond. But, you know, are you someone potentially that feels chest tightness when you're stressed, right? That could suggest that you have a phenotype or a model of constricting your blood vessels, or that's where you carry your anxiety. And then metabolic health. As we get older, as we become more sugar-coated on the inside, as we get what's called glycation happening, where our nerves and things get damaged by chronic sugar.
Right? Potentially is there a fault in communication in our carotid arteries, like our carotid body sinus that links blood pressure to the brain? Now could it be that some sensory issue is off, meaning some internal sensor of the vagus nerve? Could it be that you're so sympathetically dominant, meaning you're such in a fight or flight state all the time, chronically stressed, that your body can't cool down? And maybe dizziness is a biological protection, because if you're dizzy, you're not going to do things like exercise and get on a ladder or anything like that.
Sanjay Bhojraj MD (16:52.054)
So maybe this is a protective mechanism, but again, that's the lens through which I look at people, certainly not the lens of conventional medicine. So the key insight when you have this sort of a symptom, and I'm focusing on dizziness because that's just the reason I went to the doctor with my family member, but it could be anything. It could be fatigue. The most common complaint for people to see their doctor in the United States is fatigue. And fatigue is multifactorial. What happens? Normally you get
your thyroid checked, you get a blood count checked, and if those check out, people say, hey, you know what, you're okay. You shouldn't be having an issue. But there's so much more, right? So in my experience, and I see it repeatedly in cardiology, and now looking back at so many symptom complaints that patients had over the years, right? It is the same root causes. And I say this of functional medicine all the time, no matter which of the thousands of diseases you have, it's still probably the same couple of causes, right? Inflammation.
probably some degree of insulin resistance, stress, poor sleep, and constipation or GI issues. And the key here is that there's no medication, those upstream drivers of disease. So you can't treat lifestyle diseases with medicine. And so always on the podcast, you'll see, as we'll talk about season two, when we talk about...
We'll have somebody coming on to talk about dizziness. We'll have somebody to talk about hair loss. We're going to have someone talking about thyroid health. All of these different issues, all these different medical concerns have the same underpinning, inflammation. And the first step in the therapy for all of these things is diet and lifestyle.
Hey everybody, welcome to season two of the Curious Cardiologist podcast. Just want to run quickly through a couple of the changes that we're having in season two. First and foremost, you're listening to it right now. We are doing solo episodes weekly. Number two, we're upping the cadence. We've got so many guests that have such amazing material. We're to be doing a solo episode per week and a guest episode per week. So definitely subscribe to the podcast from there. And number three, I'm excited about a new program that I've initiated.
Sanjay Bhojraj MD (19:07.736)
called U360 or the U360 membership. What this is, it's looking at the 360 degrees of you. You're have one-on-one time with me in the U360 membership. You're gonna get a couple of benefits. Number one, you get a monthly mini master class. What does that mean? Well, we're gonna do a live deep dive into some topic. And the first one that we're gonna be talking about is metabolic health and the markers you need to know.
Second is we're going to have a Q &A session and ask me anything for members only where you can come in as part of the community, ask me your questions and potentially come on live with me to chat if you're there about what's happening. Then number three, we're going to be doing member discounts. So we've got a ton of awesome benefits coming your way in terms of discounts on devices, discounts on on supplements. We are going to be
creating our own supplement line here at the Curious Cardiologist, part of the Laguna Institute of Functional Medicine. So look out for that. And also member discounts on our programs. We have right now the GLP Rescue program for people who are on GLP medications that want to figure out how to support your body nutritionally the best you can while on those medications or how to come off of those medications and taper them safely. So that's GLP Rescue. And we've also got our Signature Well 12 program.
my cardiometabolic program that helps people reverse insulin resistance to help reverse blood pressure, meaning to normalize blood pressure, and to get you back on the road to health, where we've seen people's thyroid's get fixed, we've seen people's hormonal dysfunction get fixed, we've even seen brain fog and cognitive issues improve significantly, all from focusing on diet and lifestyle. So if that sounds great, click in the link below in the descriptor and join the U360 program.
Sanjay Bhojraj MD (20:57.686)
So getting back, no medication fixes lifestyle drivers. And as a result, we need to think of disease differently. And doctors need to doctor better, right? So what does that mean? And start asking questions about what are the drivers of what's going on? One of the most powerful patient encounters I had was a woman years ago that came, years like maybe six years ago that came to see me, and she was having palpitations, which is a very common cardiovascular complaint.
you know, in the chair across from her, was asking all the right questions, time of day, does it track with your menstrual cycle, this, that, and the other, but something just felt off, right? That doctor spidey sense just went off. And I asked a question I've probably never asked before in a clinical encounter, which is, do you feel safe? And it was a weird question, right? Not something your doctor normally asks you, but there's just something felt off. And then she proceeded to start crying.
and told me that she was in an abusive domestic relationship. And certainly not something I was prepped to handle. I don't have training in that. But the great part was I left the room, made a phone call, and got an appointment to see someone that could help her, therapist that could help her, and contact legal services or whatever was needed for her. But there was something about that connection that in just speaking with her, looking eye to eye,
feeling her energy, feeling her aura, feeling the sense of what was going on, something just led me to feel that there was not a real cardiac issue going on, but there was definitely a real issue happening. And the universe just guided me to ask the right questions, and I was able to connect her. So I think that's the important, right? The importance is once you have a doctor who listens to you, and this is why that skill needs to come back, there's a shift, right? And it really...
I stopped calling myself doctor and called myself a healer because doctoring just means that you're treating symptoms, whereas if you're a healer, you're really trying to figure out what's going on to reverse the process. And as an interventional doctor, as a heart attack specialist for 20 years, I was doing stents and procedures and adding meds, which was great. Don't get me wrong. It's very important. But I was never really healing. I never was understanding why this wasn't happening correctly for people.
Sanjay Bhojraj MD (23:14.47)
should medicine look like? Well, I feel like first thing that we should have is curiosity. Of course, I'm the curious cardiologist, but as a practitioner, as a healer, you need to be curious about what's going on and the context and why this is happening. Number two is listening. The scary statistic that happens, you know, and somebody can fact check me on this, but I think it's like in a doctor encounter within the first like seven or eight seconds, the physician is already interrupting.
patient, right? The patient starts talking and the doc just kind of chimes in like a like an unruly two-year-old, right? But the real skill needs to be in deep listening, in asking the right questions, taking it in, mirroring it back. Okay, so what I understand that you're saying is you're dizzy but it's in a few different ways. Let's explore that, right? Go into curious mode, go into, okay, well that's weird that there's three different types of dizziness. Explain that to me further.
Not dizzy equals tricyclic antidepressant. and by the way, the doc was nice enough to tell us that this is an off label use for that. So there's never actually been a clinical trial showing the dizziness. People just use it as a therapy for dizziness, right? Which is a whole other can of worms, a whole other ball of the wax. But, you know, I just wish that there had been more deep listening in that encounter to really get a better sense, a better understanding of what was happening. Pattern recognition. And this is, think, where doctors with the silver highlights in their hair
you know, really start to put things together. And this is why it's called the practice of medicine is putting together these patterns of dysfunction and realizing what this is really leaning to, but looking beyond just a disease, right? So if you turn your head and you're, the room is spinning, that's called design positional vertigo. That's a, that's a pattern of recognition, but then going that step further to not just be happy about diagnosing it, but all right, how do we really fix what's happening here?
And I just, again, I'm using dizziness as an example. Maybe it's not the best one, but getting into the behind what's happening. So if somebody has a precancerous lesion, don't just talk about stay out of the sun or don't do XYZ behavior, but really kind of say, all right, how has your stress level been? Are you sleeping correctly? What does your metabolic health look like? Are you going out in the sun when you should or out in the sun when you shouldn't if it's a skin cancer?
Sanjay Bhojraj MD (25:39.456)
looking at these deep patterns of behavior that drive a lot of disease and being open to understanding that things that we think may have worked or may be healthy might actually not be. And really looking at this in the context of someone's lifestyle. Because if someone is, for instance, say a construction worker that has skin cancer, you can't just say, well, don't go outside. mean, that person is going to have a very difficult time making a living. If you have a new mom who has young kids at home and is stressed out, you say,
you know, take an hour to yourself every day. Well, how is that gonna happen? That's a very difficult thing to do. Maybe, you know, in that instance, recommend deep breathing during nap time or something that fits in the context of the person's life, right? So sometimes when I look at it, the best treatment is not medications, right? The best medicine isn't a drug, but the best medicine could be sleep or hydration.
nervous system regulation, which I think is so important, and inflammation reduction. Looking at where inflammation is coming from. Is it emotional stress? Is it something that you're eating? Is it something that you're environmentally exposed to? Could it just be something as simple as constipation leading to reabsorption of toxins and whatnot, right? So really look at the best treatment outside of medicines as a doctor. So, you on this note, I think there's cause for some
maybe hope here because what I love about what I get to do in the podcast and the people who are listening and engaging with me on socials is that patients are waking up, right? And I think through forums like mine, through forums like the Instagram and all the people who live in my orbit in terms of practitioners, we're trying to teach you how to ask better questions and how to look at that root cause. And if your doctor's not able to do it, how to look at it for yourself.
But I also think doctors are starting to shift a little bit too. And I love when I get new docklings, I call them people who are residents, because you can see that the wheels are turning in just a different way than they were 30 years ago when I was in med school. Because when I was in med school, was just about memorization, memorization, memorization. I happened to really like people, and so I took a lot of the stories and context involved. But I think we're rediscovering how doctors should be doctors in this modern era.
Sanjay Bhojraj MD (28:00.204)
And you don't have to memorize everything because we all have smartphones with the entire canon of medical literature ever in the history of humanity in this little device. But we now have to doctor by connecting. How do we do that? Well, you listen to people. You look at people. You give people time to tell them their story. You just listen actively. And think of things in terms of a systems biology approach.
What does that mean? Well, everything is interrelated. We are not a series of arrows, but more like a spider web internally. And be aware that hormone health is associated with cardiovascular perturbations, right? So if your hormones are up or down, that can affect your heart. When I was in school, the hormone chapter was chapter three, the cardiac chapter was chapter five or whatever was in the book. And never the tweet did meet. But now in the real world, we realize, man, the context of everything is so important. We have to take
a whole person approach and really think of this like being on one of those like Law and Order or whatever detective show you like to think. I think of Hunter back in the day. Give me a thumbs up in the chat if you remember or in the comments if you remember Hunter on TV, right? But medicine is supposed to be detective work. It's not reactionary. We need to figure out the why. And don't get me wrong, in the acute setting, if you have a heart attack or a stroke, I'm not gonna sit here and say, okay, well let's...
Identify the 2250 root causes of cardiovascular disease. No, no, no, let's go in there. Let's get the blood vessel open, right? Same thing if you have a stroke, right? Let's get in there. Let's do the acute thing. But I think the doctors that are going to do really well in this new era of medicine where you don't have to memorize everything's available. Patients more than ever going to things like chat, GPT or Claude or Gemini or whatever your AI is of choice to putting in your labs and getting data. But the most important part of this is, you know, let's connect again with people.
So, you know, back getting to the title of this podcast, my first solo podcast, thank you for being here, is, you know, when did doctors stop being doctors? Well, I think we have to think of it a couple of different ways. Really, it's when did the system stop allowing docs to practice medicine properly, which is different than treating, right? So I think the future of medicine is not only remembering how to think again as healers,
Sanjay Bhojraj MD (30:26.786)
but how to connect again with our patients.
Thank you guys so much for being here as part of the first solo podcast on the Curious Cardiologist. Again, a couple of things that we're gonna do here this season that are different, the solo episodes, but number two, I really encourage you to look at the U360 membership and see one-on-one time with me if that's something that jives with you. I think I'm so excited about this. said in one of the videos I made for the promotional on that is,
It's really been about 25 years in the making. This is how I was always programmed to connect and now technology has finally caught up to allow me to connect with you in this way. I will catch you on the next Curious Cardiologist podcast.